The consortium recently held a conference for those who wanted to help.

In part it was inspired by an effort in central Michigan that relied on volunteers and ingenuity – not lots of extra money - to improve its last-place rankings.

For example access to health care improved when doctors and nurses offered to set up a free clinic.

Tackling the problems in Coos may seem like a big job, but the health consortium’s Nancy Frank envisions what amounts to a divide-and-conquer strategy.

“If you break it down and you look at very specific small things that you can do to make a difference then it doesn’t feel quite as daunting.”

Obesity and substance abuse are the top two problems in the North Country, according to a survey of about 400 people conducted by the health consortium.

So those will be the primary targets.

Sparking such a community effort is the idea behind the county rankings, says Julie Willems Van Dijk, the deputy director of the University of Wisconsin project.

“The whole point was not to rank the counties in New Hampshire and have the folks up here feel horrible or down trodden because they ranked unhealthiest. Let’s remember you ranked unhealthiest in a pretty healthy state. But really for people to say alright, let’s look at this information, let’s see what rings true to us and let’s see how we can come together to take action to improve health.”

Frank says the groups will begin meeting this summer to come up with strategies to attack the problems.